New Patients – Information & Forms

New Patients

Below are the forms that we routinely have new patients complete on their first visit. We would ask for you to submit these prior to your initial visit. If you are unable to submit these forms prior to your visit, you may download these and bring the completed forms to your appointment. If you are unable to download these forms, or if you are unable to submit these forms, please arrive 20 minutes early. All items listed below are required.

Download New Patient Forms

Please feel free to send these forms via email or fax to
receptionist@harpereyecare.com

fax: 336-993-3979